Time Trends in Consumption of Breastmilk, Formula and Animal Milk by Young Children From 2000 to 2019: Analyses of 113 Countries

Abstract

Introduction: There are no global analyses of infant and young child feeding indicators that include high-, and low- and middle-income countries (LMICs). Methods: Using data from 487 nationally representative surveys conducted in LMICs and from literature review of data from high-income countries (HIC), we report on seven indicators in up to 113 countries. National level trends were calculated and pooled by country income groups and regions of the world using multilevel linear models to estimate annual changes from 2000 to 2019. Findings: In the pooled analyses of LMICs, exclusive breastfeeding was the only indicator to show an increase, estimated at 0·70 percentage point per year (p.p.) (95% CI: 0·51,0·88). The increase was observed in all country income groups and regions of the world, except in the Middle East & North Africa. There were significant gains in breastfeeding at six months (0·59 p.p.) and at one year (0·53 p.p.) in upper-middle income countries and HICs (1·29 and 1·14 p.p., respectively), although levels remain below those observed in LMICs. Formula consumption increased in upper-middle income countries and in East Asia & Pacific, Latin America & Caribbean, Middle East & North Africa, and Eastern Europe & Central Asia, while remaining below 8% in SubSaharan Africa and South Asia. Animal milk consumption by children under 6 months significantly reduced (-0·41 p.p.) in LMICs. Interpretation: Gains in exclusive breastfeeding throughout the world, and in any breastfeeding at six and at one in HIC and upper-middle-income countries were observed at the same time that formula consumption in increasing in the latter. As a result, declining trends are observed in the consumption of animal milk. The target of 50% exclusive breastfeeding by 2025 will likely be achieved at global level, although there is variability by country and world regions. Funding: Bill & Melinda Gates Foundation.